Request Help with my WCB Claim

Injured Worker Appeal Services (IWAS) provides free legal advice and representation services for individuals with claims before the Workers’ Compensation Board (WCB). IWAS advocates are not lawyers but are specialized subject matter experts trained in administrative law and interpretation of WCB legislation, policies, procedures and the appeal process. In the course of IWAS work we can:

review your WCB claim and give advice on how to proceed;
explain the claim and appeal process;
assist you in preparing for an appeal, including analyzing legal issues, preparing arguments, assembling relevant evidence; and
provide representation at all levels of the appeal process including speaking to the WCB, providing written submissions, and representing clients at an appeal hearing.

Your WCB claim number must be filled in or you cannot submit this form.

Your Information

First Name

Last Name

Date of Birth

Mailing Address

City / Town / RM

Province

Postal Code

Phone Number 3065551234

Alternate Phone Number 3065551234

WCB Claim Details

Claim Number

Date of WCB Decision

Worker Occupation

Area(s) of Injury Explain why you disagree with the WCB decision

Authorization to Release Medical Information Form

Download and complete the Authorization to Release Medical Information form.
Upload the signed form in the box below.

Important: If you don’t sign the medical form, you will not be assigned to an advocate.

Acceptable file formats include .doc, .docx, .pdf, .jpg. Maximum file size is 10MB per file.

Upload Authorization to Release Medical Information form

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Applicant Declaration

If you have any questions regarding the declaration, please contact Injured Worker Appeal Services at 1-877-787-2456.

Claimant Terms of Agreement

I hereby request and authorize Injured Worker Appeal Services (IWAS) in Saskatchewan to assist me with my claim filed with the Workers’ Compensation Board of Saskatchewan (WCB).

I authorize the IWAS to:

Receive, store and review copies of all records, documents and other material in the possession of the WCB regarding my claim(s) as deemed necessary by IWAS.
Request and receive full disclosure of all records in the possession of any individual, business or other organization where the requested records, documents or other material are in the opinion of IWAS necessary to further my WCB claim.
Communicate directly with any individual, business or other organization concerning my claim for the purpose of furthering my WCB claim.

I have read the above and authorize IWAS to assist me with my claim filed with the Saskatchewan Workers’ Compensation Board. I understand that I can revoke this authorization in writing at any time.

I understand my personal information will be protected by safeguards, in accordance with The Freedom of Information and Protection of Privacy Act and The Health Information Protection Act.

I Agree

Applicant’s Name

Date

Contact Us

Injured Worker Appeal Services

Phone	877-787-2456 (Toll Free)
Email	appealservices@gov.sk.ca

URL	https://www.saskatchewan.ca/business
Fax	306-787-0249
Mailing Address	300 - 1870 Albert Street, Regina, SK, S4P 4W1

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